What You Need to Know to Manage High Blood Pressure and Reduce the Need of Hypertension Medication
Hypertension is a common public health problem in developed countries so much so that in the USA, one in three adults has hypertension. Uncontrolled high blood pressure leads to many degenerative diseases, including heart failure, end stage renal disease and peripheral vascular disease. There are a variety of medications that are effective in the treatment of hypertension and most patients may need at least two medications to achieve their targeted blood pressure levels. Although these medications can be very helpful and life-saving, they can also cause unwanted side effects.
Fortunately, hypertension is considered a chronic lifestyle disease which means that it is possible to manage your blood pressure and reduce your need for high blood pressure medication just by making the necessary lifestyle and dietary modifications. If you suffer from hypertension and are interested in making changes to your daily habits in order to reduce your need for hypertension medication, then this blog will tell you everything you need to know to help you reclaim your health, and life, from hypertension so you can successfully release your need for hypertension medication.
What is Hypertension?
Hypertension or high blood pressure is persistently high arterial blood pressure which is the force extended per unit area on the walls of the arteries. Blood pressure is measured in millimeters (mm) of mercury (Hg) and adult blood pressure is considered normal at 120/80 mm Hg. The systolic blood pressure (SBP) is the upper reading in a blood pressure measurement and is defined as the force that is exerted on the walls of the blood vessels as the heart contracts and pushes blood out of its chambers. The lower half of the blood pressure reading is known as diastolic blood pressure (DBP) and this measures the force as the heart relaxes between contractions. High blood pressure is defined as greater than 140/90mmHg for adults under 60 years and greater than 150/90mmHg for adults over 60 years of age.
Hypertension is usually classified into two groups, the first being essential or primary, which accounts for 90-95% percent of cases. It is caused by a combination of lifestyle choices including:
- Smoking
- Poor diet
- High sodium intake
- Low veg and fruit intake
- Stress
- Physical inactivity
- Obesity
- Genetics
In contrast, secondary hypertension is caused by other disease processes, including renal or endocrine pathophysiology. It’s important to understand that elevated blood pressure predisposes individuals to cardiovascular disease and increased risk of cardiac events, including stroke and myocardial infarction (heart attack). According to the Centers for Disease Control and Prevention, the prevalence of hypertension increases with age, with a rate of 22.4% among adults aged 18 to 39, a rate of 54.5% among those aged 40 to 59, and a rate of 74.5% among those aged 60 and older.
The overall prevalence of high blood pressure is 46%, though prevalence estimates vary by race and ethnicity.
- 44% of Hispanics
- 45% of Asians
- 47% of Caucasians
- 59% of African Americans actually have blood pressures above that threshold or report being on hypertensive medications.
The prevalence of hypertension increases with age such that 50% of all people aged 45 – 54 years and 79% of those aged ≥ 75 years are affected. Populations with a high prevalence of HBP include persons with unhealthy lifestyles, obesity, cardiovascular disease and type 2 diabetes, as well as old adults and african americans.
Screening and Criteria
Approximately 65 million Americans have hypertension, which is defined as having a resting SBP ≥140 mmHg and/or ≥ 90 mmHg, taking antihypertensive medication, or being told by a physician or other health professional on at least two occasions that a person has high BP. The relationship between BP and risk for cardiovascular events is continuous, consistent, and independent of other risk factors.
For people between the ages of 40-70, each increment of 20 mmHg in SBP or 10 mmHg in DBP doubles the risk of cardiovascular disease across the entire BP range from 115/75 to 185/115.
Patients may unknowingly become hypertensive without any overt symptoms before diagnosis. This highlights the importance of regular blood pressure monitoring. When present, symptoms may signify more severe hypertension, and include headache, fatigue, vision problems, chest pain, and arrhythmia. If you need assistance, the American College of Cardiology (ACC) has a CardioSmart Patient Education Portal that provides evidence-based resources for patients with hypertension.
In 2017, the ACC and the American Heart Association released new guidelines for managing hypertension where theory changed the definition of hypertension from a blood pressure of ≥140/90 mmHg (which is 32% of the population) to ≥130/80 mmHg (46% of the population).
Additionally, statistics from the American Heart Association reported that approximately 72,000 persons in the U.S. died from hypertension in 2013 and that the estimated cost was more than $48 billion. In 2021, the number of deaths associated with hypertension had risen to almost 700,000. Therefore, there are health and fiscal reasons why treatment and prevention of hypertension are of critical importance.
Lifestyle Modifications
Below are a list of lifestyle modifications that will help you manage your high blood and eventually reduce your need for hypertension medication:
Practice Good Dental Hygiene
Dental health and overall health go hand-in-hand as the risk factors are present for gum disease and heart disease are the same. Bacteria in the mouth from gum disease may increase C-reactive protein, a marker for inflammation in the blood vessels, and a risk for cardiovascular disease. Brush and floss daily to prevent gum disease.
Regular Exercise
Exercise enhances circulation and the filtration of toxins from the body. It also can prevent weight gain and high blood pressure, which can stress the heart and kidneys. I will go further into detail about using exercise later in this blog but for now just know that incorporating regular exercise into your lifestyle can improve your health and reduce your need for hypertension medication.
Get Adequate
Sleep Studies have shown that inadequate sleep can increase the risk of stroke or a heart attack. Getting too little sleep can increase inflammation and blood pressure. Aim to get 7-9 hours of sleep per night.
Don’t Sit Too Long
Sedentary jobs and lifestyles increase the risk for cardiovascular events and death caused by these events. Sitting for long periods increases the risk of blood clots. Be sure to move throughout the day by taking regular breaks, walking at lunch, taking the stairs instead of the elevator and parking further from the office.
Manage Stress
Stress is an underlying condition in all chronic diseases, especially hypertension. Stress hormones narrow blood vessels making the heart work hard to pump blood through narrowed passages. Its important to find ways to manage stress such as exercise, yoga, deep breathing, meditation, and journaling. I will discuss more on this topic later in this blog.
Nutritional Recommendations
While there are specific eating plans that have been known to help reduce symptoms of hypertension, there are some standard nutritional recommendations that can help you reduce your need for hypertension medication. This include:
- Avoid Trans Fats Contrary to the low-fat craze of the 90s, we need fats in our diet, including saturated fats and polyunsaturated fats. One fat to avoid, however, is trans fat found in packaged baked goods, snack food, margarines and fast foods. Trans fat is known to raise blood pressure as well as increase your risk for heart disease and stroke. Read labels and avoid products with partially hydrogenated oils in the ingredients.
- Emphasize a Whole-Food Diet Avoid processed foods, sugar, refined carbohydrates, trans fats and fried foods, and foods that contribute to inflammation. Eat a whole-foods, plant-based diet rich in vegetables, fruits, whole grains, nuts and seeds, healthy fats, and lean proteins.
- Stay Hydrated Getting enough water prevents your heart from working too hard. Water helps the heart pump blood through the blood vessels and muscles to remove wastes. A general rule of thumb is to drink half of your body weight in ounces of water per day. For example, if you weigh 150 pounds, you should drink at least 75 ounces of pure, filtered water. An additional 4 ounces is recommended for every 15 minutes of intense physical activity but this varies from person to person. If you tend to be a heavy sweater, one thing you can do is weigh yourself before and after a workout to see how much weight you lost through sweating and then drinking 8 oz. of water for every pound you lost.
Nutrition has been recognized as a pivotal part of modifying the risk of cardiovascular disease for some time. The role of diet has been focused on individual dietary components, however due to the fact that foods are consumed in combination and the possibility of the beneficial relationships between nutrients, there has been increasing attention to overall dietary patterns as opposed to just individual nutrient consumption. Dietary approaches including the Mediterranean, DASH, Vegetarian and Vegan eating plan are often recommended to patients at risk of or diagnosed with CVD and have all been proven to be successful in helping individuals reduce their blood pressure as well as reduce the need for high dosages of blood pressure medication. Not sure which one would fit your lifestyle? I will explain them in detail below:
The DASH eating plan (DEP)
The DEP advocates consuming fiber and potassium via fruits, vegetables, and whole grains, reducing sodium intake, reducing total sodium intake, reducing total and saturated fat, as well as getting adequate protein via lean meat and low fat dairy products instead of high-fat or processed meat.
The DEP has been shown to be effective for managing BP and one study using the DEP reported a drop in systolic blood pressure of 11.4 mmHg and a decrease in diastolic blood pressure of 5.5 mmHg. Many individuals have reported having problems adhering to the DEP when using the low-fat version, but find it easier when they allow moderate-higher fat dairy options into the eating plan.
Surprisingly enough, research has shown that using a version of the DEP that incorporates full-fat dairy along with a moderate reduction in carbohydrates actually produced similar reductions in both systolic and diastolic blood pressures without any increases in low-density lipoprotein numbers.
The Mediterranean Eating Plan (MEP)
The MEP is believed to prevent cardiovascular disease and other chronic diseases. Some consider it to be the world’s healthiest diet, as it primarily features plants, whole grains, as well as healthy fats and oils. Specifically, monounsaturated fats (mainly from olive oil) and wild-caught fatty fish are commonly consumed in that part of the world which is thought to be one of the reasons why tis particular eating plan is so effective.
I would also like to add that consuming too much seafood or fish can put you at risk for mercury poisoning. It’s important to use make sure that you are also getting your protein from non-meat sources to ensure that you are not susceptible to this.
The Vegetarian Eating Plan
Adopting a vegetarian may also be difficult to adhere to since you do not eat meat or fish and most people use them as their main sources of protein. Though consuming meat and fish isn’t necessarily bad, animal protein may be difficult for the body to digest, and modern methods of raising livestock have become somewhat unethical and unhealthy.
If you are considering adopting a vegetarian or vegan eating pattern, make sure to fulfill your nutritional needs by eating mainly fresh, organic, whole produce. Some vegetarians rely too much on processed foods instead of vegetables when it is entirely possible to meet daily protein needs on a vegetarian diet through lentils, beans, and even broccoli! Just keep in mind that just like many meat-eating individuals, you may need to supplement with B12.
Vegan Eating Plan
Like vegetarians, vegans don’t eat animal meat or fish, but they also don’t eat any animal by-products – such as butter, eggs, yogurt, gelatin, and sometimes honey. While this diet is restrictive, your vegan clients can get all of their nutritional requirements by eating primarily fresh, organic, whole produce.
Like vegetarians and many meat-eaters, they may need to take a B12 supplement since B12 is a bacteria found in soil and is often difficult to obtain in your diet. Similar to vegetarians, trouble arises when vegans rely too much on processed foods. After all, food manufacturers are more than happy to market their packaged foods as “vegan-friendly” which is why it’s important to avoid this tempting trap.
If your goal is to lower your blood pressure and reduce your need for hypertension medication on a vegan diet, then you will not be able to do so if you consume too many of these processed foods.
Exercise Considerations
Researchers suggest that resistance training affects your cardiovascular system differently than aerobic exercise, so a workout that includes both is a winning combination. Weight and resistance training increases blood flow to the extremities and can lower blood pressure. It also builds muscle mass which can support weight loss and heart health.
Mind-body exercises such as yoga and tai chi are increasingly being incorporated into exercise training programs to promote flexibility, strength and relaxation. The combined effects on blood pressure of physical activity and relaxation, as practiced through mind-body exercise, appear to be greater than when practiced separately or alone.
Of course there are precautions that should be taken when deciding to participate in mind-body exercises while suffering from hypertension. For starters, many styles of hatha yoga involve isometric muscle contractions which can cause significant increases in blood pressure. In addition, individuals taking certain antihypertensive medications may experience dramatic decreases in blood pressure when changing body position. With that being said, the following tips are recommended for individuals considering in engaging in physical activities to manage hypertension:
- If you have severe or uncontrolled BP should add exercise training to their treatment plan only after first being evaluated by their physician and being prescribed antihypertensive medication
- For individuals with documented cardiovascular disease, such as ischemic heart disease, heart failure, or stroke, vigorous-intensity exercise training is best initiated in rehabilitation centers under medical supervision such as a cardiac rehab facility.
- If your resting SBP is > 200 mmHg and/or DBP >110 mmHg, do not exercise. When exercising, one should aim to maintain ≤ 220 mmHg and/or DBP ≤ 105 mmHg
- When doing yoga, avoid holding strenuous or inverted poses
- Avoid various forms of hot yoga such as Bikram due to the impaired thermoregulatory mechanisms seen in person’s with hypertension
- Aim for a combination of aerobic exercise and weight training (HIIT, Circuits, Step, Kickboxing etc.) to maximize your health benefits
- When performing resistance training one should avoid the Valsalva maneuver since it can raise one’s BP
- 𝜷-blockers, particularly the nonselective types, may reduce your exercise capacity primarily in individuals who do not experience myocardial ischemia. As a result, one should use a perceived exertion scale to monitor your exercise intensity
- Antihypertensive medications such as α-blockers, calcium channel blockers and vasodilators may lead to sudden reductions in post-exercise BP. It is recommended to extend and monitor the cool-down period carefully in these situations
- Many individuals with hypertension who are overweight or obese should focus on increasing your caloric expenditure coupled with reducing caloric intake to create a caloric deficit that will assist in reducing body fat and BP
- The BP-lowering effects of aerobic exercise are immediate, which is a physiologic response commonly referred to as postexercise hypotension. Being aware of this fact may help you adhere to keeping aerobic exercise in your weekly physical activity routine. The results of some previous studies suggest that the postexercise hypotension observed is sufficient in magnitude and duration to significantly lower the average 24-hour ambulatory BP level.
- For those with documented episodes of ischemia, it is recommended to set your exercise intensity below the ischemic threshold (≥ 10 beats · min –¹)
Relaxation Techniques
There is sufficient evidence showing that chronic stress contributes to hypertension. However, various mindfulness practices and relaxation techniques have been investigated for their potential to mitigate the symptoms of hypertension. Among these techniques, Transcendental Meditation has demonstrated a significant reduction in blood pressure and should be considered as a lifestyle modification to manage hypertension.
Other relaxation techniques may also be effective, including mindfulness, massage and bodywork, tai chi, acupuncture, or journaling. These techniques show potential in reducing hypertension-related symptoms and could be beneficial in managing overall blood pressure. Other relaxation techniques to be considered include:
- Increasing your self-care routine
- Working with a therapist, coach or other mental health professional to increase your mental resilience
- Crystal healing
- Reiki healing
- Acupuncture or acupressure
- Aromatherapy
- Deep breathing exercises
- Biofeedback
- Music or Art Therapy
- Doing anything that honor your inner child such as playing video games, doing puzzles or any hobby that you enjoyed as a child (or anything you wanted to do as a child but was unable to)
Relief is Possible
Hypertension affects or will affect many people over their lifetimes. Untreated, this condition can become progressively worse, wreaking havoc in various areas of their lives. With adequate treatment however, BP can be reduced to acceptable levels. It is important to note that the majority of these new patients can be treated with lifestyle changes instead of medications, with the biggest impacts coming from changes in diet and exercise.
Other lifestyle changes include managing stress, losing weight, and getting adequate sleep, have all proven effective in preventing and managing hypertension. Doing these things will effectively shift the emphasis of care for patients with hypertension from treatment, to prevention but, it is unclear whether patients and clinicians are ready for such a change. It is also unclear whether the many more people classified as having hypertension can find appropriate support and guidance for effective and sustainable lifestyle modifications. As a result, there is a great need for qualified healthcare professionals, including wellness coaches and nutritionists, to help clients prevent and manage hypertension without medication.
If you need help managing your high blood pressure to reduce the need of medication and possibly avoid other serious health issues and medical procedures, then visit the services section to learn more about how you can work with a holistic nutritionist to create a personalized wellness plan that will help you improve your health and reclaim your life in the process. I hope this helps.
In Good Health,
Amber Stewart BS,
Holistic Nutritionist
Certified Master Life Coach
ACSM Exercise Physiologist
CTNC Mental Health Specialist
TBMM Corrective Exercise Specialist
Hi! My name is Amber and I’m a Body Goals Builder, Master Life Coach, Certified Health Coach, CTNC Mental Health Specialist, Stress Alchemist & Fear Conqueror
I used to be a people pleasing, work-a-holic who stressed herself out to climb the wellness industry’s corporate ladder but when years of chronic stress and anxiety made me spiral into a deep depression, I realized that none of it mattered if I wasn’t happy with myself, inside and out, and surrounded around people who loved and respected me.
I now help individuals who are stressed out, out of shape and struggling to find balance in their lives learn how to ease their worries, improve their health, create 10x more joy in their lives and manifest the life of their dreams. At the STEW Project, we are maximizing our living potential by Simply Taking an Emphasis on Wellness.